| Popis: |
Background: Post infectious bronchiolitis obliterans (PIBO) is a serious disease in children. The chest computed tomography (CCT) lesions are varied. The correlation between the severity of clinical symptoms and the importance of radiological signs is poorly reported. Aims: To study the role of the CCT in PIBO in children at diagnosis. Methods: Our study was retrospective including all patients with PIBO diagnosed between 2013 and 2017 and having CCT at diagnosis. All data were collected from the medical records. Results: Fourteen patients were collected with a mean age at diagnosis of 16 months. The offending viruses were Influenzae B (n=2), metapneumovirus (n=2), adenovirus (n=1) and respiratory syncytial virus (n=1). The CCT was performed at 3 months on average after the initial viral infection. The most frequent CCT findings were: alveolar condensation with peribronchial thickening (n=14), mosaic pattern (n=9), bronchiectasis (n=7) of which 4 diffuse and bilateral, atelectasis (n=6) and air trapping (n=3). Under corticosteroids, 5 patients were asymptomatic with rare exacerbations, and 4 had permanent wheezing without severe exacerbations. Five patients died after a follow-up of 2.5 years on average. Three of them had developed severe pulmonary arterial hypertension and required long-term non-invasive ventilation. Patients with severe or fatal PIOB (n=9) had extensive initial radiological lesions with predominance of severe bronchiectasis and diffuse air trapping. Conclusions: CCT has contributed to PIOB diagnosis in all cases especially in the absence of virology. The severity of the initial radiological lesions seems to be correlated with poor prognosis. |
